1. Field of the Invention
The present invention relates to devices for use in the treatment of female urinary incontinence and a method of treating female urinary incontinence by lifting the pelvic floor to create a steeper posterior angle between the urethra and the bladder.
2. Description of the Prior Art
To treat female urinary incontinence the pelvic floor is lifted to create a steeper posterior angle between the urethra and bladder. To do this, a surgical technique is used to suspend the pelvic floor from the pubic bone by a suture sling. This surgery is conventionally accomplished by making an incision in the lower abdomen of the patient right above the pubic bone and by approaching the pelvic floor and bladder through the pre vesical space, outside the abdominal cavity. The pelvic floor is sutured to the pubic bone or hung with a suture to the top of the pubic arch.
With the laparoscopic technique; we are able to do the same surgery with staples without having to make traditional open surgical abdominal incisions. This not only reduces the amount of pain experienced by the patient and the length of her hospital stay, it also allows the patient to return to work and other activities much sooner than presently known techniques. The devices used in the laparoscopic technique include an urethral sound, a stapling device, and a staple saw.
One commonly known urethral sound used in urological surgical procedures is, for example, the Van Buren urethra sound manufactured by Dittmar Penn Corporation of the United States. This is an elongated, substantially circumferential, stainless steel sound having a curved end and located opposite the curved end, a flattened end. The curved end is representative of a probe tip and the flattened end is representative of a handle to assist in the manipulation of the urethral sound. Unlike the present invention to be described hereinafter, the Van Buren urethral sound has a smooth surface as opposed to having beads protruding therefrom.
Stapling devices used for suturing are well known in the art. One such stapling device is shown, for example, in Yaroslav P. Kulik U.S. Pat. No. 4,784,137 issued Nov. 15, 1988. Kulik discloses a surgical suturing instrument comprising a handle and a staple jaw extending therefrom. Kulik describes a supporting jaw hingedly attached to the staple jaw permitting the jaw to pivot 180 degrees. The supporting jaw may extend axially or may pivot to a position parallel and juxtaposed to the staple jaw. An alternative stapling device is shown in Odis L. Avant et al. U.S. Pat. No. 4,873,977 issued Oct. 17, 1989. Avant et al. describes a stapling method and apparatus for vesicle-urethral re-anastomosis. The apparatus includes a tubular urethral sound having an inflatable anvil connected thereto. A second implement comprises a connector engagable with the urethral sound. The second implement includes a circular blade for severing a circular opening to allow flow between the bladder and the urethra. A catheter is attached to the anvil and upon the removal of the second implement is closed by a conventional surgical procedure. The anvil upon deflation is withdrawn through the urethra to position the catheter to drain the bladder during the healing of the anastomosis. David T. Green et al. U.S. Pat. No. 5,040,715 issued Aug. 20, 1991 teaches of an apparatus and method of placing staples in laparoscopic and endoscopic procedures. The apparatus places staples and makes incisions. When used in endoscopic procedures, the apparatus includes an anvil member which is mounted to the distal end of an elongated housing. A tubular collar disposed around the arm of the anvil member is movable to bias the anvil member and cartridge assembly into cooperative alignment, thereby clamping the body tissue to be fastened therebetween. Robert G. Oddsen et al. U.S. Pat. No. 5,125,553 issued June 30, 1992 discloses yet another a surgical suturing instrument and method. The surgical instrument staples a hernial opening in internal body tissue. The instrument comprises an elongated staple cartridge rotatably mounted to an elongated frame and an elongated staple forming plate movably mounted to the frame for ejecting a staple from the cartridge into the body tissues and for deforming the staple from an open position to a closed position. This enables the staple to hold together two pieces of body tissue. The instrument further includes a rotator assembly operatively connected to the cartridge for rotating the cartridge.
Surgical staples used in conjunction with stapling devices are also well known in the prior art. One such staple is shown in Clyde R. Pratt et al. U.S. Pat. No. 4,454,875 issued Jun. 19, 1984. Pratt et al shows an osteal medical staple having a cross-bar portion defining gripping surfaces and depending leg portions flaring outwardly a predetermined amount, ensuring that a discrete, constant flaring is obtained once the staple is implanted in the bone. Loosening or reversal of the staple is eliminated by the triangular cross-section of the leg portions. Securing spikes on the under surface of the cross-bar portion are for attaching the soft tissue to the bone. Clyde R. Pratt et al. U.S. Design Pat. No. 281,814 issued Dec. 17, 1985 illustrates a osteal medical staple similar to that shown and described in the above referenced Pratt et al. patent. An alternative surgical staple is shown in Lanny L. Johnson U.S. Design Pat. No. 284,509 issued Jul. 1, 1986. Johnson shows a surgical staple having a cylindrical head and two semi-cylindrical legs. The head includes a centrally disposed threaded bore. The legs flare outwardly.
Also well known in the art are surgical saws. E. J. Greenfield U.S. Pat. No. 1,179,910 issued Apr. 18, 1916 shows, for example, a gear driven surgical saw which is manually driven through wrenching an axially aligned handle. British Patent 218,942 published Jul. 17, 1924 for Allen et al. also shows a gear driven surgical saw. Allen et al., however, teaches of a saw which is manually driven through the rotation of a radially offset wing shaped handle. Another surgical saw is shown in Mitchel Langworthy U.S. Pat. No. 1,417,669 issued May 30, 1922. Langworthy describes a surgical saw which is gear driven by an electric motor.
Other patents which may be of general interest include British Patent No. 1,044,633 published Oct. 5, 1966 for Alexander Ivanovich Boorlakov et al., Herbert W. Korthoff et al. U.S. Design Pat. No. 286,442 issued Oct. 28, 1986, Robert L. Conta et al. U.S. Pat. No. 4,606,343 issued Aug. 19, 1986, Joseph J. Berke, U.S. Pat. No. 4,887,598 issued Dec. 19, 1989, and Ray M. St. Marie U.S. Pat. No. 4,979,307 issued Dec. 25, 1990.
None of the above inventions and patents, taken either singly or in combination, is seen to describe the instant invention as claimed.